Recirculating cooling system for energy delivery device

ABSTRACT

An energy delivery device cooling system includes a reservoir connector assembly and an elongate member. The elongate member has first and second lumens in fluid communication with the reservoir. The first lumen includes an outflow port and the second lumen includes a return port each in fluid communication with the reservoir. The device further includes a tubing system having a first end and a second end. The first end connected in fluid communication with the outflow port and the second end in fluid communication with the return port. The second end configured to return a fluid to the reservoir. The tubing system connects to an energy delivery device to cool the fluid.

CROSS-REFERENCE TO RELATED APPLICATION

This application is a divisional application of U.S. patent applicationSer. No. 14/811,129, filed Jul. 28, 2015, which is a continuation ofU.S. patent application Ser. No. 13/835,625, filed Mar. 15, 2013, nowU.S. Pat. No. 9,101,344. The entire contents of each of the aboveapplications are hereby incorporated by reference.

BACKGROUND 1. Technical Field

The present disclosure relates to the use of energy delivery devices.More particularly, the present disclosure is directed to cooling systemsfor energy delivery devices.

2. Background of the Related Art

Energy delivery procedures such as tissue ablation are used in numerousmedical procedures to treat many conditions. Ablation can be performedto remove undesired tissue such as cancer cells. Ablation procedures mayalso involve the modification of the tissue without removal, such as tostop electrical propagation through the tissue in patients with anarrhythmia condition. Often the ablation is performed by passing energy,such as electrical energy, through one or more electrodes and causingthe tissue in contact with the electrodes to heat up to an ablativetemperature.

Electromagnetic (EM) ablation may also be used instead of direct energydischarge into tissue. For example, microwave (MW) ablation is a commonexample of such EM ablation where energy is applied to tissue throughmicrowave radiation. EM ablation devices may require cooling to operatewithin desired parameters without damaging the ablation device orcausing unintended tissue damage. Examples of EM ablation medicaldevices include percutaneous needle ablation probes and flexibleintraluminal ablation catheters. Some devices implement cooling systemsincluding a peristaltic pump that forces saline or another fluid througha tubing system operably connected to an energy delivery device. Thesaline solution draws heat from the energy delivery device and is thenpumped out into a receptacle or to a drain. However, these systemsrequire constant supply of saline bags, can be wasteful, and can beinefficient.

SUMMARY

Like reference numerals may refer to similar or identical elementsthroughout the description of the figures. As shown in the drawings anddescribed throughout the following description, as is traditional whenreferring to relative positioning on a surgical instrument, the term“proximal” refers to the end of the apparatus that is closer to the userand the term “distal” refers to the end of the apparatus that is fartheraway from the user. The term “clinician” refers to any medicalprofessional (e.g., doctor, surgeon, nurse, or the like) performing amedical procedure involving the use of embodiments described herein.

One aspect of the present disclosure is directed to a medical devicecooling system including a reservoir connector assembly connectable to areservoir and a tubing system. The reservoir connector assemblyincluding an elongate member, an outflow port, and a return port. Theelongate member extends into the reservoir. The elongate member has afirst lumen in fluid communication with the reservoir and the outflowport and has a second lumen in fluid communication with the reservoirand the return port. The tubing system has a first end in fluidcommunication with the reservoir through the outflow port and a secondend in fluid commutation with the reservoir through the return port. Thetubing system is configured to cool the medical device. The elongatemember may include a third lumen and a fourth lumen. Each of the thirdand fourth lumens in fluid communication with the reservoir throughoutflow ports.

In embodiments, the system includes a pump configured to pressurize afluid in the tubing system. The pump may be a peristaltic pump.

According to a further aspect of the present disclosure, the systemincludes a drip chamber connected downstream of the outflow port. Inembodiments, the drip chamber may include a fluid flow indicator. Thefluid flow indicator may be a rotating cylinder or a semi-buoyantspinning cube. The system may also include a thermal diffusion deviceconfigured to draw heat from the fluid and diffuse the heat to anambient environment. The reservoir may be a saline bag. In someembodiments, the system includes an elbow member connected to and inbetween the second end of the tubing system and the return port of thereservoir.

Yet a further aspect of the present disclosure is directed to a fluidreturn elbow for use with medical device cooling systems. The elbowincludes a body defining a lumen, an inflow port in fluid communicationwith the lumen, and an outflow port in fluid communication with thelumen. The inflow port is configured to connect to a return section of afluid tubing system. The outflow port is configured to connect to areturn port of a reservoir connection assembly. In embodiments, theelbow includes a flange disposed around the outflow port to ensureproper alignment of the elbow with a reservoir connection assembly. Theinflow port of the elbow may be configured to connect to tubing of acooling system for a medical device. The outflow port of the elbow maybe configured to connect to a return port of an elongate member insertedin a fluid reservoir such as saline bag.

Still a further aspect of the present disclosure is directed to a systemfor cooling a medical ablation device. The system includes a fluidreservoir, a tubing system, a pump, a medical ablation device, and afluid flow indicator. The fluid reservoir is configured to hold acooling fluid. The tubing system connects the fluid reservoir to themedical device in fluid communication. The pump attaches to the tubingsystem and induces fluid flow from the fluid reservoir through thetubing system. The cooling fluid flows through the tubing system fromthe fluid reservoir and through the medical device before returning tothe fluid reservoir. As the cooling fluid flows through the medicalablation device, the cooling fluid draws heat from the medical ablationdevice. The cooling fluid may be recirculated into the fluid reservoirand reused. In embodiments, the system includes at least one thermaldiffusion device that facilitates thermal diffusion from the coolingfluid to the environment. The fluid flow indicator provides visualindicia of cooling fluid flow through the system. The fluid flowindicator may be a bubble indicator, a venturi device, a drip chamberindicator, a float type indicator, a hall-effect indicator, or anelectromagnetic indicator.

BRIEF DESCRIPTION OF THE DRAWINGS

The above and other aspects, features, and advantages of the presentdisclosure will become more apparent in light of the following detaileddescription when taken in conjunction with the accompanying drawings inwhich:

FIG. 1 is a side view of a portion of a cooling system in accordancewith the present disclosure;

FIG. 2 is a cross-sectional view of a drip chamber and flow indicator,in accordance with the present disclosure;

FIG. 3 is a perspective view of a flow indicator of a cooling system inaccordance with the present disclosure;

FIG. 4A is an exploded view of a portion of the cooling system inaccordance with the present disclosure;

FIG. 4B is a side view of the portion of the cooling system of FIG. 4A;

FIG. 5A is a cross-sectional view of a fluid return elbow member inaccordance with the present disclosure;

FIG. 5B is a front view of the fluid return elbow of FIG. 5A;

FIG. 5C is a bottom view of the fluid return elbow of FIG. 5A;

FIG. 6 is a side view of a cooling system in accordance with the presentdisclosure;

FIGS. 7A and 7B are cross-sectional views of a drip chamber and a flowindicator, in accordance with the present disclosure; and

FIG. 8 is a side view of a cooling system in accordance with the presentdisclosure depicting locations of flow sensors and thermocouples.

DETAILED DESCRIPTION

Particular embodiments of the present disclosure are describedhereinbelow with reference to the accompanying drawings; however, thedisclosed embodiments are merely examples of the disclosure and may beembodied in various forms. Well known functions or constructions are notdescribed in detail to avoid obscuring the present disclosure inunnecessary detail. Therefore, specific structural and functionaldetails disclosed herein are not to be interpreted as limiting, butmerely as a basis for the claims and as a representative basis forteaching one skilled in the art to variously employ the presentdisclosure in virtually any appropriately detailed structure.

In accordance with at least one aspect of the present disclosure, anenergy delivery device cooling system is disclosed. Referring generallyto FIGS. 1-6, the system 1000 includes a reservoir connector assembly100 in communication with a reservoir 200. The reservoir 200 isconfigured to contain or hold a cooling fluid. The reservoir connectorassembly 100 may include an elongate member 101 configured to extendinto the reservoir 200. Tubing system 400 connects the reservoir 200with a medical device having inlet and outlet ports and forming a closedloop cooling system 1000, as will be described in greater detail below.Examples of medical devices to which the system 1000 may be connectedcan be found in commonly owned U.S. Pat. Nos. 8,334,812 and 8,430,871and U.S. Patent Publication Nos. 2014/0281961 and 2014/0046315, theentire contents of each of which are incorporated herein by reference inits entirety.

In some embodiments, the elongate member 101 can have any length andshape capable of being inserted into the reservoir 200. For example, theelongate member 101 can be a spike with a penetrating tip. In otherembodiments, the elongate member 101 can have a blunt or substantiallyflat tip. The elongate member 101 can be substantially cylindrical, andin the embodiments with a piercing tip, the tip can be symmetricallyconical or non-symmetrically conical.

Referring specifically to FIG. 2, the elongate member 101 has at least afirst lumen 105 and a second lumen 107 defined therethrough. Each lumen105, 107 is configured to be in fluid communication with the reservoir200 shown in FIG. 1 at openings 105 a and 107 a respectively. The firstlumen 105 may act as an inflow lumen for drawing fluid from thereservoir 200 and the second lumen 107 may act as a return lumen forreturning fluid to the reservoir 200.

Lumens 105, 107 and openings 105 a, 107 a may have the same or differentdiameters. The diameter of the lumens 105, 107 may be selected based ona desired volumetric flow rate and fluid velocity for a given medicaldevice. For example, to promote mixing in the reservoir 200, a smallerdiameter lumen 107 can be chosen to achieve a higher velocity of thefluid for a given pressure. The increased velocity can increaseturbulent flow within the reservoir 200 and/or the tubing system 400,resulting in increased mixing of the fluid. This increased mixing canpromote homogenization of the fluid temperature within the reservoir 200and/or the tubing system 400. The turbulent flow can also increase theefficiency of the transfer of heat from the fluid to the surroundingenvironment.

At least one outflow port 109 is in fluid communication with the firstlumen 105 and allows fluid to flow from the reservoir 200 into a dripchamber 300 or directly into the tubing system 400. With continuedreference to FIG. 2 and added reference to FIG. 4A, the reservoirconnector assembly 100 includes a return port 103 configured to allowcooling fluid to return to the reservoir connector assembly 100 from thetubing system 400. The return port 103 is in fluid communication withthe second lumen 107 and may be configured to allow for direct orindirect fluid communication with tubing system 400. It is alsoenvisioned that the reservoir connector assembly 100 includes more thanone return port 103.

In some embodiments, the elongate member 101 further includes a thirdlumen and a fourth lumen having third and fourth openings, respectively,and in fluid communication with the reservoir 200 and the outflow port109. Similarly, added lumens may also connect to the return port 103.

The elongate member 101 or the reservoir 200 may include a thermocouple202 operably connected thereto to monitor a temperature of the fluidinside the reservoir 200. Alternatively, the thermocouple 202 may beplaced in various locations to measure the temperature of the fluid inthe system 1000, as shown in FIG. 8. For example, the thermocouple 202may be placed near the opening of the second lumen 107 to measure thetemperature of the fluid flowing into the reservoir 200, near the firstlumen 105 to measure the temperature of the fluid flowing out of thereservoir 200, in a portion of the tubing system 400 to measure thetemperature of fluid flowing therein, or any combination thereof. Thethermocouple 202 may be connected to an energy source for the medicaldevice, for example a microwave generator (not shown), and may beemployed as a safety shut off for the energy source such that if thetemperature of the fluid rises beyond a set threshold that indicatesinsufficient cooling, the energy source is shut off to prevent undesireddamage to patient tissue during treatment.

As shown in FIG. 1, a reservoir connector assembly 100 fluidly connectsthe reservoir 200 with a drip chamber 300. The drip chamber 300 mayinclude a top portion 301 (FIG. 4A) configured to receive a portion ofthe reservoir connector assembly 100 and a bottom portion 303 configuredto connect the drip chamber 300 in fluid communication with the tubingsystem 400. In embodiments, a fluid connector 305 connects the bottomportion 303 with the tubing system 400 and facilitates fluidcommunication therebetween. Between the top portion 301 and the bottomportion 303 is a central portion 307, which may be formed as a cylinder.As shown in FIGS. 2, 7, and 8, the central portion 307 of the dripchamber 300 may also include a flow indicator 309 for indicating that afluid is flowing from the reservoir 200 through the drip chamber 300 tothe tubing system 400.

As shown in FIG. 3, the flow indicator 309 may be formed of a hollowcylinder 310 with hydrofoils 311 configured to rotate the hollowcylinder 310 in the drip chamber 300 when fluid flows through the flowindicator 309. The flow indicator 309 may include a design 313 disposedon an outer surface thereof that visually indicates that the cylinder309 is rotating, and thus that fluid is flowing therethrough. Forexample, the design 313 may resemble a barber-shop pole, however, otherdesigns can be used to indicate fluid flow, for example a corporate logoCOVIDIEN® or other graphic design. The cylinder 310 may be formed of amaterial with a specific gravity causing the cylinder 310 to either beneutrally buoyant in the cooling fluid or to float in the cooling fluid.Other embodiments of flow indicators 309 may be utilized that aresuitable for indicating flow in the drip chamber 300 including but notlimited to low density balls, floating material indicators, paddle wheelindicators, or the like.

An alternative arrangement of a flow indicator 309 a is depicted inFIGS. 7A and 7B. As shown in FIGS. 7A and 7B, the flow indicator 309 ais generally in the shape of a cube, though other geometric shapes maybe employed without departing from the scope of the present disclosure.The cube shape may be advantageous by eliminating the possibility of theflow indicator 309 a occluding the bottom portion 303 of the dripchamber 300 when the system 1000 is initially primed with the fluid. Theflow indicator 309 a has a density related to the cooling fluid suchthat when fluid is not flowing through the drip container 300 the flowindicator 309 a floats to the upper surface 700 of the fluid in the dripcontainer 300 as shown in FIG. 7A and when fluid is flowing through thedrip container 300 the flow indicator 309 a partially submerges beneaththe surface 700 and may also rotate to provide visual indicia of fluidflow as shown in FIG. 7B.

The tubing system 400 may include one or more return fluid flowindicators disposed thereon to indicate that a fluid is returning fromthe medical device to the reservoir 200 through tubing system 400.Examples of such return flow indicator include bubble indicators andtraps, Venturi-style indicators, Hall-effect fluid flow indicators, andthe like. Indicators, such as bubble indicators and venturi devices,also have the dual purpose of removing any gas which may have enteredthe system or vapor from the liquid flow to prevent disruption in theflow. Other fluid flow indicators may also be employed to measure fluidvelocity, pressure, or volumetric flow rate. Examples of the fluid flowindicators are currently sold by Introtek International under the nameBDC and BER Ultrasonic Clamp-on Air Bubble, Air-in-line & Liquid levelDetection Systems as well as the Drip Chamber Ultrasonic Liquid LevelSensors.

FIG. 8 illustrates numerous locations where flow indicators 309 b andthermocouples 202, as described above, may be employed within system1000. The flow indicators 309 b are flow sensors that detect flow of afluid between portions of the flow indicators 309 b. The flow indicators309 b and thermocouples 202 may be attached to various portions of thesystem 1000 and may be attached to devices (not shown) that provideaudible and/or visual indicia of fluid flow within the system 1000.Further, the devices themselves may provide audible and/or visualindicia when fluid is not flowing within portions of the system 1000,e.g. when a tube is kinked or blocked.

Referring now to FIGS. 1 and 2, the tubing system 400 includes one ormore tubes 401 that allow a fluid to flow from the reservoir connectorassembly 100, through an energy delivery device (not shown) such as anablation needle or catheter or an energy source, and back to thereservoir connector assembly 100. The tubing system 400 may include afirst end 403 and a second end 405.

In the illustrated embodiment, the first end 403 is in fluidcommunication with the outflow port 109, either indirectly through thebottom portion 303 of drip chamber 300 or by direct connection tooutflow port 109, and is configured to allow fluid to flow into tubingsystem 400. The second end 405 is in fluid communication with the returnport 103, and is configured to allow fluid to return to the reservoir200 through the second lumen 107.

Tubing system 400 may also include one or more thermal diffusion devices407 configured to draw heat from the fluid and diffuse the heat to theambient environment. As shown in FIG. 1, the thermal diffusion device407 includes a series of fins 409 in contact with the tube 401 returningfrom a medical device. A fan may be employed to direct airflow over thefins and increase the cooling effect. While shown connected to the tube401, a thermal diffusion device 409 could also or alternatively beemployed on the reservoir 200. A further alternative could employpassing the tube 401 returning from the medical device through areservoir containing cold water or ice water in order to further drawheat out of the fluid flowing through the tubes 401.

The system 1000 may further include an elbow member 500 connected to thesecond end 405 of the tubing system 400 as shown in FIGS. 5A-C. Thesecond end 405 of the tubing system 400 in fluid communication with thereturn port 103 through the elbow member 500.

The elbow member 500 may include a body 501 defining a lumen 503, aninflow port 505 in fluid communication with the lumen 503, and anoutflow port 507 in fluid communication with the lumen 503. The inflowport 505 is configured to connect to a return section or second end 405of a tubing system 400, and the outflow port 507 is configured toconnect to or accept the return port 103 of the reservoir connectionassembly 100.

The elbow member 500 may further have a flange 509 disposed around theoutflow port 507 to ensure proper alignment of the elbow 500 with thereservoir connection assembly 100 as shown in FIGS. 4A and 4B. Forexample, as shown, flange 509 has a tombstone shape with a flat portionon a bottom portion thereof to allowing for connection with return port103 in only one orientation of the elbow 500.

In at least some embodiments, the elbow 500 is formed of molded plastic.The elbow 500 may be injection molded, blow molded, or formed in anyother suitable manner known in the art. The elbow 500 may be made of onesolid piece or a conglomeration of subparts.

In one embodiment, one or more pumps may be used to control fluid flowthrough the cooling system 1000. Referring to FIG. 6, a pump 600 may beconnected to the tubing system 400 to pressurize a fluid in the tubing401. While any pump known in the art can be used, as shown FIG. 6, thetype of pump 600 used is a peristaltic pump which applies pressure tocompress the outside of a pump tubing 602 forcing fluid downstreamtowards the medical device. The pump tubing 602 may be made of a thickergauge of the same material or a different material than the tubing 401,thus allowing it to withstand the repetitive stresses of the peristalticpump for the duration of a medical procedure. Connectors 604 may be usedto fluidly connect the pump tubing 602 to the tubing 401. Further, aprotective slip cover 606 may alternatively be used to protect eitherthe pump tubing 602, or the tubing 401, if no pump tubing 602 isutilized. Though described herein with respect to a peristaltic pump,any device suitable to create a pressure to advance fluid through thetubing 401 in the cooling system 1000 may be used.

As an alternative to using a peristaltic pump 600, the entire system1000 may rely on gravity and the change in density of the fluid as it isheated to allow the fluid to circulate through the system 1000. Forexample, as water heats, its density at 1 atm (sea level) decreases fromabout 62.4 lb/ft³ at 60° F. to about 60 lb/ft³ at 212° F. Thisdifference in density may in some circumstances promote sufficientcirculation of the fluid through the system 1000 to maintain propercooling of the medical device.

The fluid used in cooling system 1000 may be any suitable liquid such assaline solution, de-ionized water, sugar water, and combinationsthereof, or the like. For example, the reservoir 200 may be a saline bagtraditionally used in medicine.

In use, the tubing system 400 is connected to a medical device (notshown) to cool the medical device. The medical device may have coolinglumens such as those found in microwave ablation probes and microwaveablation catheters. The tubing system 400 connects to an inflow port ofthe medical device allowing cooling fluid to flow through the lumens ofthe medical device to and flow out of an outflow port on the medicaldevice. The cooling fluid may pumped from the reservoir 200 through themedical device, as described above, or alternatively, the cooling fluidmay be gravity fed to the medical device. The cooling system 1000 mayinclude the reservoir connection assembly 100 and the drip chamber 300in fluid communication with the tubing system 400, as described above.The cooling fluid flows from the reservoir 200 through the reservoirconnection assembly 100, drip chamber 300, and the tubing system 400into the inflow port of the medical device. The fluid returns to thereservoir 200 flowing from the outflow port of the medical devicethrough tubing system 400, the return port 103, and the second lumen 107of reservoir connection assembly 100. The fluid extracts or absorbs heatfrom the medical device to cool the device. As the fluid is travelingthrough system 1000, it releases some heat into the environmentsurrounding the tubing system 400. If thermal diffusion devices 407 areconnected to the system 1000, heat may be released from the fluid moreefficiently, allowing for a reduced operating temperature of the system1000.

Temperatures maintained in the system 1000 and the energy deliverydevice should be within a range to avoid injury to the patient andadequate to allow flow through the system. For example, the temperatureshould be below approximately 113° F. to avoid injury to the patient andabove the freezing temperature of the fluid. Pressures and flow rateswithin the system 1000 and the components thereof may be varied throughvariations in pump speed, and through design of the system 1000 and thecomponents thereof.

Some example performance parameters include:

Microwave Needle Microwave Pump Ablation Probe Ablation CatheterPressure 35-45 psi 45-55 psi 50-70 psi Up to 60 psi Flow Rate 4.8-6.1in³/min 4.2-5.5 in³/min 1.4-1.8 in³/min

One of the advantages of the cooling system 1000 described herein isthat it can employ standard sterile saline bags as the fluid reservoir,which eliminates the need for a specialized fluid source. Further thesystem 1000 recirculates fluid as opposed to simply dumping the coolingfluid after one pass through the medical device, thereby conservingcooling fluid and eliminating the need for a collection bucket or bag.

Methods are also disclosed herein. In an embodiment, a method mayinclude providing a saline bag or other fluid reservoir and a saline bagelongate member having multiple lumens defined therein. The saline bagelongate member includes at least one return port connected to at leastone of the lumens. The method may also include providing a dripcontainer such as the drip container 300 disclosed herein.

The method may further include providing an elbow 500 as disclosedherein. The method further includes connecting the elbow 500 to thereturn port of the saline bag elongate member to allow fluid flow toreturn into the saline bag through the return port. The method alsoincludes the step of connecting a return portion of the tubing system400 to the elbow 500.

Also disclosed is a method for recirculating a cooling fluid for usewith an energy delivery device. The method includes providing an energydelivery device, providing a recirculating cooling system connected tothe energy delivery device, and recirculating a fluid through thecooling system and energy delivery device to maintain the energydelivery device at a desired temperature or within a desired temperaturerange to prevent undesired damage to tissue. The desired temperaturerange may include an upper limit corresponding to a temperature abovewhich tissue is damaged and a lower limit below which the fluid will notflow within the system. The flow rate of fluid within the system may beadjusted as the temperature approaches the upper limit or the lowerlimit. For example, when the temperature approaches the upper limit theflow rate may be increased to increase the cooling of the medicaldevice. The system may include visual or audible indicia when thetemperature approaches the upper or lower limit.

It should be understood that the foregoing description is onlyillustrative of the present disclosure. Various alternatives andmodifications can be devised by those skilled in the art withoutdeparting from the disclosure. Accordingly, the present disclosure isintended to embrace all such alternatives, modifications, and variances.The embodiments described with reference to the attached drawing figs.are presented only to demonstrate certain examples of the disclosure.Other elements, steps, methods, and techniques that are insubstantiallydifferent from those described above and/or in the appended claims arealso intended to be within the scope of the disclosure.

1-20. (canceled)
 21. A fluid return elbow, the elbow comprising: a bodydefining a lumen, the lumen having a first port configured to connect toa return section of a fluid tubing system and a second port configuredto connect to a return port of a reservoir connection assembly; and aflange disposed around the second port configured to ensure properalignment of the elbow with the reservoir connection assembly.
 22. Theelbow according to claim 21, wherein the flange defines a tombstoneshape.
 23. The elbow according to claim 21, wherein the first port isconfigured to connect to tubing of a cooling system for a medicaldevice, and wherein the second port is configured to connect to a returnport of an elongate member inserted into a saline bag.
 24. A system forcooling a medical device, the system comprising: a fluid reservoirconfigured to hold a cooling fluid and having a connection port; areservoir connector assembly defining a first lumen in fluidcommunication with the fluid reservoir and a second lumen in fluidcommunication with the fluid reservoir, the reservoir connector assemblyincluding a fluid flow indicator in fluid communication with the firstlumen to provide local indicia of the flow of cooling fluid from thefluid reservoir through the first lumen; a tubing system in fluidcommunication with the fluid reservoir via the reservoir connectorassembly; a pump connected to the tubing system and configured to inducethe cooling fluid to flow from the fluid reservoir through the firstlumen and to return cooling fluid to the fluid reservoir through thesecond lumen; and the medical device connected to and in fluidcommunication with the tubing system, the medical device to allowing thecooling fluid to flow therethrough and draw heat therefrom.
 25. Thesystem according to claim 24, further comprising a thermal diffusiondevice to facilitate thermal diffusion from the cooling fluid disposedin the system.
 26. The system according to claim 24, wherein the fluidflow indicator is selected from the group of fluid flow indicatorsconsisting of bubble indicators, venturi devices, drip chamberindicators, float type indicators, hall-effect indicators, andelectromagnetic indicators.
 27. The system according to claim 24,wherein the tubing system includes a first tube and a second tube, thefirst tube connected to and in fluid communication with an outflow portof the reservoir connector assembly and an inflow port of the medicaldevice, the second tube connected to and in fluid communication with anexit port of the medical device and a return port of the reservoirconnector assembly.
 28. The system according to claim 24, furthercomprising a drip container connected to and in fluid communication withan outflow port of the reservoir connector assembly and the tubingsystem.
 29. The system according to claim 24, further comprising anelbow connected to and in fluid communication with a return port of thereservoir connector assembly and the tubing system.